Objective :To compare the value of ovarian crescent sign (OCS) and various sonomorphologic scoring systems in consolidating pre-operative suspicion of ovarian malignancy in adnexal masses. Materials and Methods :A prospective study was carried out in 60 consenting women with an undiagnosed adnexal mass requiring operative intervention. OCS was considered to be present if normal ovarian tissue was seen adjacent to the tumor area on ultrasound. Various other sonological parameters were noted to calculate five morphological scoring systems. Doppler velocimetry study values were available in 27 cases. The results were compared for correctness of suspicion with histopathologic examination report of the tumor obtained at surgery. Results :Eleven of 60 specimens showed histopathologic diagnosis of malignancy. OCS was identified in 97% of the benign masses. The sign was not seen in 10 of the 11 cases with malignancy. Sensitivity and negative predictive value of crescent sign was better than values obtained for the compared sonomorphological indices and Doppler velocimetry studies. Conclusion :Ovarian crescent sign is a reliable and simple sonographic indicator comparable to sonomorphological indices and Doppler flow velocimetric studies for the preoperative detection of malignancy in adnexal masses.

Background :Intestinal worm infestation is widely prevalent in developing countries and can result in impaired nutrition and development. Aims: To estimate prevalence of and risk factors for intestinal geohelminths and other intestinal parasites in children aged 6 to 23 months. Settings and Design: Cross sectional study in rural India. Materials and Methods: Proportionate population size sampling method was used to randomly select 15 villages per block. Thereafter, house-to-house survey was done to recruit eligible children and obtain fecal sample for microbiological examination. Statistical Analysis: Univariate distribution of variables was assessed and comparison between categorical variables and continuous variables was done using a Chi-square test and student's t-test, respectively. Odds ratio was calculated to assess associations. Results: Overall 926 children were recruited and 909 fecal samples examined. Combined prevalence of infestation with intestinal geohelminths treatable by albendazole and other intestinal parasites non-treatable by albendazole was 50.3% (457/909) and 51.6% (469/909), respectively. Exclusive use of hand pump water (OR = 1.79, CI = 1.36-2.35, P < 0.001) and use of hand pump water plus field defecation increased risk of geohelminthic infection (OR = 1.75 CI = 1.34-2.30, P < 0.001) while use of well water (OR = 0.45 CI= 0.33-0.60, P < 0.001) and exclusive use of soap and water practice for hand washing after defecation was protective (OR = 0.54, CI = 0.40-0.73, P < 0.001). Conclusion: Since almost half the children are infected with intestinal geohelminths treatable by albendazole, targeted deworming of population in this age group should be considered.

S. pneumoniae continues to be a major cause of invasive disease worldwide with considerable mortality and morbidity. Here we report the emergence of penicillin intermediate resistance to S. pneumoniae in India, which may predispose for an increased incidence of invasive pneumococcal disease in both children and adults with multi-drug resistance profile resulting in clinical failure.

Diabetic retinopathy (DR) remains one of the leading risk factors and causes of blindness worldwide. Tight metabolic and blood pressure control has been shown to significantly decrease the risk of development as well as progression of retinopathy and remains a cornerstone in the medical management of DR. Laser photocoagulation and vitrectomy are important tools for preventing severe visual loss from sight-threatening DR and its complications. New pharmacological therapies to target the underlying biochemical mechanisms that cause DR are also being evaluated in order to overcome the limitations of current treatment modalities. In this context, the role of protein kinase C inhibitors, intravitreal injections of steroids, vascular endothelial growth factor inhibitors, angiotensin converting enzyme inhibitors such as candesartan, and growth hormone inhibitors is promising. Although treatment can help prevent blindness in a majority of cases, the key variable in the success of therapy lies in identifying patients with retinopathy before their vision is affected. This calls for timely eye examination of diabetic patients. The present article is a comprehensive review of DR with special emphasis on its pathophysiology and management aspects.